FREE CASE EVALUATION
Please complete the entire form below so we may carefully analyze your claim. Red fields are required.
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Were you paid overtime for working for more than 40 hours per week?
Yes
No
Are you still employed with the company?
In No, when did you stop working for the company (Month/Year)?
Approximately, how many total hours per week did you usually work?
What was your rate of pay?(ie: $15 / hour)
What was the title of your job?
How many employees work for the company now?
Under 10
10-25
25-50
50-100
100+
How many employees do you think are not receiving overtime pay?
Are there any other comments you have that we should consider that relate to your overtime or wage claim?
Full Name:
Email Address:
Address:
City:
State:
Zip:
Phone #
Alternate Phone #
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Assisting California Employees by Providing a Free Wage Claim Review
United Employees Law Group, PC 110 Pine Avenue - Suite 725 Long Beach, CA 90802 Phone: (877) 696-8378 Fax: (866) 435-7471 client@paymeovertime.com
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